The article on Buprenorphine in “Addiction Treatment With a Dark Side,” The New York Times, November 17, 2013, is a kind of morality tale for today’s out of control pharmaceutical based psychiatry. In truth you cannot treat a drug addiction by addicting a patient to a different drug. Even if you make the case that this cuts down on crime, it is very misleading. It creates more addiction and hurts the patients it proposes to help. One can write an even more more graphic and disturbing article on the misuse of methadone in the addict world. Addicts take drugs to get high. We are fooling ourselves to think otherwise. An addict will tell a doctor anything to get drugs. Real treatment is abstinence based.
This applies well beyond opiate use. The history of psychiatric drugs, with the exception of anti-psychotics and Lithium, all follow the same pattern. Each new drug arrives in the market with great acclaim. Each one is advertised to be efficacious, with no side effects, no addiction, no habituation, no drug tolerance (requiring higher and higher doses), and no high. Then, each in turn shows itself to be horribly addictive, with terrible side effects, with considerable drug tolerance, and significant habituation, while the highly acclaimed efficacy shows itself to have been fraudulent. And they end up being used simply for their considerable “highs.” Keep in mind, when each drug gets discarded, new ones appear to take its place, with the same false promise—efficacious, no side effects, not addictive, no habituation, no drug tolerance, and no high. We move so quickly to the next new drug that we don’t seem to remember the travesty that has just transpired.
This applies to the bromides; chloral hydrate; Milltown; the barbiturates; the old benzodiazepens like Valium and Librium (the new substituted ones are the same); the amphetamines (even though they are back in favor having been thoroughly and correctly discredited in the 1970’s and 1980’s when there was tremendous addiction and the psychiatric wards were filled with amphetamine psychoses. Now apparently speed is safe again and it is prescribed to children as a really good idea.) It applies to the sedatives and sleep drugs. There never has been a safe, effective, non-addictive sleep drug and there never will. Ambien et al, have habituation, considerable drug tolerance, and very bizarre psychoactive side effects like sleep driving or sleep eating.
And finally we come to the antidepressants Prozac et al. They too are horribly addictive, build tolerance, the efficacy is fraudulent, and they are extremely difficult to get off of because they generate an array of frightening neurological symptoms appear when trying to detox off this psychoactive brain drug—vertigo, lightheadedness, burning or tingling sensations in the skin, difficulty with gait and balance, blurred vision, tremors, twitches, and restlessness. Sometimes there are hallucinations. The ‘depression’ returns because the patients is habituated to external supplies of Serotonin and can’t make enough of their own. (Psychotherapy actually heals the brain in a healthy way.) Patients, understandingly, get terrified from these symptoms and conclude that something really is dangerously wrong with their brain. As a result they don’t dare to stop the Prozac. Thank God they are taking it in the first place and blocking these horrible neurological symptoms that are part of their brain disease. To discontinue an SSRI has to be done very slowly and carefully, and takes over a year.
Psychiatry, pharmaceutical psychiatry has lost its way. We need to treat our patients well and to do so means good psychotherapy.
Robert A Berezin, MD
Author of “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain.”